| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,479.17 | $2,479.17 | $2,479.17 | |
Cigna
| Facility | $3,737.39 | $3,737.39 | $3,737.39 | |
Cigna
| Professional | $3,737.39 | $3,737.39 | $3,737.39 | |
Providence
| Facility | $3,737.39 | $3,737.39 | $3,737.39 | |
Providence
| Professional | $1,474.23 | $2,885.92 | $4,407.89 | |
United
| Professional | $2,421.98 | $2,794.60 | $4,879.93 |